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6,jILDING PERMIT APPLICA11jN <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425-257-8810 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 00"St SW PARCEL#: 00480600102000,00480600102104 <br /> EVERETT <br /> CITY STATE WA ZIP 98204 <br /> SUITE/UNIT#: Bldg E Units FLOOR#: 1-3 ADDITIONAL LOCATION INFORMATION (if applicable): Bldg E <br /> TENANT/BUSINESS NAME(if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Benton Square Lot No.: 21-23 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:PACIFIC RIDGE HOME- DRH - LLC <br /> OWNER MAILING ADDRESS: STREET 17921 BOTHELL EVERETT HWY,SUITE 100 <br /> CITY BOTHELL STATE WA ZIP 98012 <br /> OWNER PHONE:(425)438-8444 OWNER EMAIL: RLClancy@drhorton.com <br /> CONTRACTOR COMPANY NAME:Pacific Ridge Homes- DRH LLC <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):Pacifrd851 JB CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET 17921 Bothell Everett Hwy Ste 100 <br /> CITY Bothell STATE WA ZIP 98012 <br /> CONTRACTOR PHONE:425.939.1164 CONTRACTOR EMAIL:RLClancy@drhorton.com <br /> PRIMARY CONTACT: ❑OWNER n CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425.939.1164 <br /> Rhonda Clancy Or Jason Atkin CONTACT EMAIL:RLClancy@drhorton.com or JWAtkin@drhorton.com <br /> JIBUILDING INFORMATION <br /> VALUATION OF WORK: $887,612.34, 3 .7$ ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of airlabor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING:N/A <br /> PROPOSED USE OF BUILDING:MULTI-FAMILY RESIDENTIAL <br /> HEAT SOURCE: ❑Gas ❑✓Electric ❑Other <br /> BUILDING TYPE: ❑SFR ✓❑Townhouse ❑Duplex ❑ADU ❑✓Multi-Family-#Units:3 ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ✓❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Change of Use <br /> []Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK: <br /> New 3 story, 3 unit townhome - 2018 building code <br /> 13ur ) IGl in� C <br /> I F3 <br /> ACKNOWLEDGEMENT.1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.l am the owner,or l am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 08.23.23 PERMIT# Pj�-� <br /> Owner/Authorized Agent SignattWe Date (Revised 412112022) <br />